A model for enhancing prevention of mother to child HIV transmission in a low resource setting

Abstract Background The prevention of mother-to-child transmission (PMTCT) programmes plays a significant role in the reduction of human immunodeficiency virus (HIV) infections in the under-five age group and maternal mortalities. A phenomenological study on the experiences of HIV-positive women who utilised the PMTCT services identified challenges affecting the use of those services. An enabling environment is required for the effectiveness of the PMTCT programme. Purpose The purpose of this paper is to develop and describe a model for enhancing prevention of mother-to-child HIV transmission in a low-resource setting. Method The model was developed in three sequential phases: empirical foundation, development of the model and description of the model. The model was developed using Walker and Avant’s steps of theory development. Chinn and Kramer’s criteria were used to evaluate the model and the modified version of the Delphi technique was utilised for peer review and further refinement of the model. This emanated from findings of a doctoral thesis on the experiences of HIV-positive PMTCT clients at a central hospital in Zimbabwe. The procedure involved the use of systems theory, central concept identification, a literature review, the definition of key terms and the identification of the elements of the model, after which the model was developed, described, and evaluated. Results The elements of the model encompass the context, input, process and outcome. Conclusion The model will act as a reference framework for midwives and programme planners with a view of enhancing utilisation and the quality of PMTCT services.